Altering the course of the diabetes epidemic requires a diverse array of effective changes in policies and the environments in which people live, work, and play. While prevention of type 2 diabetes (T2D) is a critical public health goal, little is known about the effectiveness of large-scale policies and programs that could help achieve this goal at the population level, or any differential effects on sub-populations. This renewal provides a platform and framework for the rigorous empirical observational study of the health impact of new and imminently available population-targeted diabetes-related programs and policy innovations by federal, state, local governments, healthcare organizations, community organizations, or businesses. New activities will construct a multi-sectoral approach to preventing T2D, related disparities and risk factors and reduce diabetes-related disparities and complications. Renewal funds will support the following: Component A: Natural Experiment Research Centers to support a 5-year multi-center network of independent research centers to evaluate innovative, health system and non-health system-based natural experimental approaches that alter the diabetogenic characteristics of US communities. Applicants must select only one of the following two tracks: ? Track 1 Evaluation of population-level programs or policies that affect population-level risk factors for type 2 diabetes (such as diet or physical activity, as well as other health behaviors; glucose; prediabetes), or ? Track 2 Evaluation of programs or policies aimed at improving care and management of diabetes, and the risk for diabetes complications. Component B: Coordinating Center to provide organizational, logistic and communication support to enhance the efficiency, productivity, and public health impact of the Natural Experiments research centers that are funded as part of Component A. Funded projects are expected to include a focus on the social determinants of health.